Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1013517838 |
---|---|
Provider Name | Candace Taylor |
First Address | Denver, CO 80222-7440 |
Second Address | Denver, CO 80222-7440 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2020 |
Last Update Date | 30/10/2020 |